Ventricular septal defects (VSDs) comprise the most common congenital heart defect at birth. The chances of spontaneous closure of VSD depend on the size and location of the defect. Subpulmonic location is an unlikely site for the VSD to close spontaneously and known to have complications such as aortic valve prolapse and regurgitation. Percutaneous closure has become the preferred strategy for small-moderate-sized VSDs located in muscular, perimembranous areas. https://www.selleckchem.com/products/tpx-0005.html Subpulmonic location poses concerns due to the close proximity to the aortic valve. Herein, we present a case of percutaneous device closure of a subpulmonic VSD using ADO I occluder device.We describe the use of a novel interventional approach to the histopathologic diagnosis of a ventricular septal tumor using intraoperative ultrasound-guided trans-epicardial biopsy without the need for cardiopulmonary bypass in a 2-year-old child. This novel approach has not been previously reported. Multidisciplinary collaboration between cardiothoracic surgery, cardiology, cardiac imaging, and interventional radiology provided the ability to perform cardiac biopsy. This technique may be used in specific cases of cardiac tumors where tissue diagnosis is important, but surgical resection is deemed excessively risky or impossible.Scimitar syndrome is a clinical triad of anomalous pulmonary venous drainage, lung hypoplasia, and anomalous aortic blood supply to the lung segment. When there is dual pulmonary venous drainage both to inferior vena cava and left atrium, it is called scimitar variant. A young child presenting with recurrent chest infections, dextroposition of the heart, and scimitar shadow on chest X-ray was identified to have scimitar variant after a detailed evaluation and managed successfully by catheter interventions. This report discusses the embryogenesis and angiographic findings of scimitar variants, indications for interventions, and issues in its management.We report the case of a 16-year-old girl diagnosed with myocarditis, although initial echocardiographic imaging was consistent with hypertrophic cardiomyopathy (HCM). The diagnosis of myocarditis was made with the findings of troponin elevation, presence of influenza A, and a more characteristic electrocardiogram. She eventually made a full recovery. Clinicians must be vigilant for such rare presentations of myocarditis masquerading as HCM.Isolated left ventricular hypoplasia is an entity with uncertain natural history and etiology. The presentation could vary from being asymptomatic to sudden death. This form of cardiomyopathy has been reported in infants as well as in adults. This case report aims to alert physicians to this diagnosis and the undeniable advantage of cardiac magnetic resonance.Heart failure due to congenital heart disease and cardiomyopathies is a significant burden in the pediatric population. Pharmacological strategies for the management of pediatric heart failure are largely based on the extrapolation of adult data and Delphi process based on expert opinion. There are differences in the etiology, clinical course, and outcome of pediatric heart failure as compared to adult, thus the results of adult heart failure trials cannot be simply extrapolated to pediatric patients. There have been a lot of newer drugs for adults with heart failure, but there is a void for pediatric population with heart failure due to many reasons. Early results of multi-centric randomized control PANORAMA HF Trial and subsequent Food and Drug Administration approval for Angiotensin Receptor and Neprylisin Inhibitor (Sacubitril / Valsartan) for pediatric patients have tried to fill in this void and paved the way for a newer class of drugs for heart failure with proven benefits in pediatric patients.There are no established criteria to decide suitability for Fontan fenestration closure. Our institution has the following criteria an unobstructed Fontan pathway with no significant decompressing venovenous collaterals, baseline Fontan pressure ?15 mmHg, baseline cardiac index ?2 L/min/m, and a decrease in cardiac index ?20% with test occlusion of the fenestration.
The objective of the study was to review midterm outcomes following device closure of Fontan fenestration using institutional criteria.
A retrospective review was performed of patients who underwent catheterization with prior fenestrated Fontan procedure between May 2005 and January 2015. Patients were classified as those who underwent successful closure (A), had closure deferred due to failure to meet criteria (B), or were not referred for closure (C).
There were 42 patients in Group A, 10 in Group B, and 150 in Group C. The mean Fontan pressure increased from 13.1 ± 2.1 to 14.5 ± 2.1mmHg in Group A and 14.6 ± 1.5 to 15.7 ± 2.2 mmHg in Group B (= not significant). With test occlusion, cardiac index fell by 18.12% ± 15.68% in Group A and 33.75% ± 14.98% in Group B (= 0.019). At a median of 46 month follow-up, oxygen saturation increased significantly from 85.15% ± 6.29% at baseline to 94.6% ± 4.43% (&lt; 0.001) in Group A but with no statistically significant difference in the rates of plastic bronchitis, protein-losing enteropathy, stroke, or heart transplantation between the three groups.
Using institutional criteria, transcatheter device closure of Fontan fenestration was followed by significant increase in oxygen saturations and no statistically significant difference in morbidity or mortality between closure and nonclosure groups.
Using institutional criteria, transcatheter device closure of Fontan fenestration was followed by significant increase in oxygen saturations and no statistically significant difference in morbidity or mortality between closure and nonclosure groups.There are limited data regarding critical congenital heart disease (CCHD) from middle-income countries (MIC). This study aims to determine the birth prevalence, rate of late diagnosis, and influence of timing of diagnosis on the outcome of CCHD.
Retrospective observational cohort study in the State of Johor, Malaysia.
All infants born between January 2006 and December 2015 with a diagnosis of CCHD, defined as infants with duct-dependent lesions or cyanotic heart disease who may die without early intervention. The late diagnosis was defined as a diagnosis of CCHD after 3 days of age.
Congenital heart disease was diagnosed in 3557 of 531,904 live-born infants and were critical in 668 (18.7%). Of 668, 347 (52%) had duct-dependent pulmonary circulation. The birth prevalence of CCHD was 1.26 (95% confidence interval 1.16-1.35) per 1000 live births, with no significant increase over time. The median age of diagnosis was 4 days (Q1 1, Q3 26), with 61 (9.1%) detected prenatally, and 342 (51.2%) detected late.